A Chat with Neurosurgeon Dr. Sanjay Vhora

Neurosurgery

Que.: Dr. Vhora, what kind of temperament do you need to be a successful Neurosurgeon? What qualities do the best brain surgeons share?
Ans.: I think that one of the key things that a good brain surgeon should have is calmness - you have to be a calm person. You should be able to think very rapidly under fire when things are not going well, quickly evaluate all the alternatives. You also should be decisive. You need to have a tremendous amount of confidence in your abilities, because if you don’t have it you’re certainly not going to inspire confidence in your team. The difficult thing is having the right degree of confidence without being arrogant.

Que.: Dr. Vhora, why did you choose neurosurgery and not other area of medicine? What makes this field interesting to you?
Ans.: I chose neurosurgery because that’s where my gifts and talents were. When I entered medical school, I was not sure about my specialization Then I started thinking about, what I was really good at? I recognized I had a tremendous amount of eye-hand coordination.May be because I was excellent Table Tennis player, had it not been medical field I would have played at National level. May be my this skill would have been otherwise wasted.

I was a very, very careful person – never knocked things over and said, “oops.” I had the ability to think in three dimensions, which means I was very good at spatial relationships. I also loved to dissect things. So I put all that together and I said, “You would be a terrific brain surgeon.” I constantly encourage young people to examine their gifts and talents and choose a field that would allow them to take advantage of those gifts. Now, as a caveat I have to say: When you think of gifts and talents, don’t just think about singing or dancing or throwing a ball, but think about intellectual talents and skills, because we all have them. We need to identify our potentials.

My Motivations

Que.: What keeps you determined with that can-do attitude when everyone tells you can’t?
Ans.: First of all, I know a lot about the human brain, and I happen to know that average brain can process more than two million bits a second and that it remembers everything you ever see and everything you ever hear. With a brain like that, and tremendous powerful frontal lobes we have – which can extract information from the past and the present, formulate a plan and project it into the future (something no other animal can do) – I think there’s really no reason to ever utter the words “I can’t.” Having said that, I have to ask the question: Is reading difficult? Most people would say no. Why? The reason is, they know all 26 letters of the alphabet. What if they only knew 21 of the 26? Let’s say they knew all except a, e, n, s and t. Can you imagine how difficult it would be to read anything? You’d give up in frustration. Math, chemistry, physics: they’re all the same – they’re just like reading. If you have the building blocks they’re easy. If you have big gaps they’re almost impossible. And that’s what people have to understand.

Que.: Who were your major influences growing up? Who did you look up to?
Ans.: I was trained in J.J. Group of Hospitals between 1988 to 1991 and I was working with Prof.K E Turel who is Micro Neurosurgeon. Even at that time he use to practice it diligently He was very hard working I was very raw at that time. He gradually and patiently polished me. I am thankful to him for his pain staking efforts for forgiving my all shortcomings in every aspect of my life.

Following that I had worked with Prof. S.N.Bhagwati at Bombay Hospital, where I got extensive exposure to various Neurosurgical cases. Also experience from various National and International Neurosurgeon like Prof.Majid Sami, Prof. Yasargil, Prof. Robin Sengupta and also different National Faculty like Prof. Rajshekhar, Prof. Ganpati, Prof. Ramamurthy, Prof, Shastri

I am also influenced by Prof. C.D. Deopujari, Prof. Sunil Pandya, Prof. Goel, Prof. M. P Chaudhari and not the least Prof. D.A. Palande.

I learned different and varied things from everyone

Rare Cases

Que.: You recently performed a clipping of aneurysm surgery? Can you share your experience?
Ans.: Clipping of Aneurysm surgery is done at our institution about 12 to 15 times a year, which itself is large no of cases The success rate is about 95% and there would be risk of 5%. Patient can have hemiplegia, Vegetative state etc and even in worst scenario even death

Post Op Care

Que.: Dr. Vhora, do you maintain contact with your patients? Do you continue to monitor their progress after surgery is performed?
Ans.: Yes, we see patients in follow up clinic until they’re completely stable, and then we see them as and when needed after that. But we get lots of Greeting cards, letters of appreciation and photographs, and it’s one of the more gratifying part of practising medicine. I’m sitting in my office right now and I’m looking at lots of pictures of patients clicked over past many years.

Que.: How do you cope with the loss of a patient?
Ans.: The best way to cope with the loss of a patient is to know that you have done everything you could possibly do. As long as I’ve done my best, then I know the rest is not up to me. I give God the credit for all the wonderful things that happen. I respect God's decisions

Que.: Dr. Vhora, God has truly blessed you with your medical skills. Do you see "miraculous" healings from time to time?
Ans.: Yes, I’ve seen numerous miracles infact too numerous to count. There are - things I can’t explain, and things no one else can explain either. I’m very glad that there is an eternal power greater than me, because if it ended with me we all will be in trouble.

General FAQs

Que.: How many day’s patient need to be admitted Prior to major Brain or Spine surgery?
Ans.: Normally I would like to admit patient 2 day’s Prior to surgery, so that pre-operative work up and pre anaesthesia checkup would be done, Also operative plan can be finalized. Patient's and relatives' counselling is also important prior to surgery

Que.: How many days patient need to stay in hospital after Brain Surgery?
Ans.: Normally after major Brain operation patient would be in Neuro Intensive care for a day or two, then he would be shifted to ward and if everything is well, would be discharged after 8 to 10 days

Que.: Normally after how many days stitches of Brain and Spine Surgery would be removed?
Ans.: Normally after Brain Surgery stitches are removed after 8 days and after spine surgery about 10 days

Que.: After Spine surgery what precaution to be taken?
Ans.: Normally patient should use Lumbar belt for a period of 2 months and then would be gradually weaned of. I suggest using western toilet for a period of 3 months, and he should refrain from bending and lifting weight.

Que.: How frequently patient should attend follow up after spine and brain surgery?
Ans.: Normally we seen them once a month for couple of months and then 3 monthly followup

Que.: Is it necessary to take Radiotherapy or chemotherapy after Brain Tumour surgery?
Ans.: It depends on the nature of the Brain tumor. If it is malignant Brain tumor normally Radiotherapy and Chemotherapy needs to be planned.

Que.: Is there any side effect of Radiotherapy or Chemotherapy?
Ans.: Now a days with advanced or 3rd generation radiation unit. It has practically become harmless. The newer oral chemotherapy treatment has minimal side effect and better compliance and tolerance